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Direct Billing – Health Insurance Claim Forms

FirstMed can arrange for the payment of medical services—such as visits and tests—directly with your insurance company. Find your form here.

In the direct billing program, we can arrange for the payment of medical services—such as visits and tests—directly with your insurance company. We assist with completing all the necessary insurance claim forms and send them to your insurer.

This saves you time and helps you get the most out of your health insurance coverage.

FirstMed has established relationships with over  110 private insurance providers  to facilitate medical claims conveniently.

Health insurance claim forms for direct billing:

The most common types of documents are available on request. If your insurance is on the list below, please fill in the form and send it to  phonenurse@firstmedcenter.com , or bring it to your consultation.

If you have booked a  Telemedicine consultation  with us, please complete and return the claim form  before your appointment .

Complete the forms with BLUE ink, not black

How to process your claim before your visit?

Completed claims forms should be scanned and returned to:  insurance@firstmedcenter.com .
If there is a Guarantee of Payment to accompany your visit, please attach that as well.

Feel free to  contact our Insurance Manager,  Ilana Varga , if you have any questions.